In Miami-Dade and 15 other counties in Florida, the Florida Department of Health is offering free access to PrEP [Pre-Exposure Prophylaxis] drugs to qualified applicants.
Health officials said they expect the program to expand to Broward, Palm Beach, Monroe, and the rest of the state’s counties by the end of 2018. The other counties offering free PrEP now are Alachua, Bay, Citrus, Desoto, Duval, Flagler, Gulf, Hernando, Highlands, Indian River, Jackson, Lee, Okaloosa, Sarasota, and Walton.
According to the Centers for Disease Control [CDC], PrEP is designed to be taken by “people at very high risk . . . and can stop HIV from taking hold and spreading. It is highly effective for preventing HIV if used as prescribed, but it is much less effective when not taken consistently.” The CDC estimates it reduces the risk of getting HIV from sex by more than 90 percent. Among intravenous drug users, it reduces the risk by 70 percent. People who use condoms while taking PrEP can further reduce their risk.
“One of the Department’s priorities is to reduce the incidence of new HIV infections. Ensuring PrEP to those at highest risk for HIV infection, regardless of their ability to pay, is one of the four key components of the Agency’s plan to eliminate HIV transmission and reduce HIV-related deaths,” wrote Mara Gambineri, communications director for the Florida Department of Health, in an email to SFGN.
“Patients requesting PrEP services are evaluated clinically and if indicated, based on CDC clinical guidelines, are able to receive immediate access to PrEP medications. Consideration is then given to every patient based on their eligibility requirements, which includes their financial status and assisting them with access to PrEP services. The PrEP initiative includes the following activities: client education, HIV testing, Hepatitis C testing, liver function test, prescription of PrEP medications, three-month follow up after PrEP initiation [which includes additional labs, and education on prevention behaviors, such as safer sex and condom usage],” wrote Gambineri.
Asked what the financial requirements were, Gambineri wrote that there is no maximum income to receive assistance obtaining PrEP. “However, other factors such as whether the client has private insurance are considered.”
While some studies have shown PrEP to be up to 99 percent effective it is not a guarantee against infection.
According to POZ magazine, a gay man taking PrEP in 2016 contracted HIV. “Evidence suggests that the individual in question, a 43-year-old Canadian man who has sex with men, adhered well to PrEP over the long-term. Nevertheless, after 24 months on Truvada he tested positive for HIV.”
POZ also quoted Richard Harrigan, PhD, director of the lab program at the British Columbia Center for Excellence in HIV/AIDS in Vancouver, Canada. “This case demonstrates that while PrEP is beneficial, we can’t rely on it to be an infallible magic bullet.”
Those interested in obtaining PrEP assistance should contact their local health departments. A list of private PrEP providers can be found at preplocator.org.